Specific anatomic region	Adrenal
Application	Evaluate incidentaloma
Author	Elliot K Fishman, MD
Reference Source	JHU Protocol
Scanner Used	Siemens Sensation 64
KV/Effective mAs/ Rotation time (sec)	120 / 250/ 0.5
Detector Collimation (mm)	0.6
Slice thickness (mm)	1- 3mm
Pitch	0.75
Kernel	30
Reconstruction interval	1-3mm
Image order (acquisition)	Cr-ca
Oral contrast	1000 cc water
IV contrast volume and type	Non contrast first and then IV if needed (see below)
Injection rate	3-cc/sec (if used)
Scan delay (sec)	For contrast 30 sec- 15 minutes
3D technique used	Not routinely needed
Comment: 1. Do a noncontrast CT first and if attenuation under 10Hu and it is 4 cm or less it is an adenoma and you can stop. 2. If above 20Hu you can inject 100 cc of contrast and look at the washout value (check Hu at 1 minute and then at 5 thru 15 minutes to look for a 50% washout value).